is generally considered to be the most difficult of all plastic surgery operations. This is due to many factors, including:

  • Previous structural damage

  • Scar tissue from previous surgery

  • Unpredictable healing

  • Unpredictable swelling

  • Increased infection risk

  • Need for much more grafting

It is very common in revision surgery to need other materials (See Donor Materials). This is due to the terminal damage that is often discovered in the revision nose. This may include removal and reconstruction of the bottom of the septum (caudal septum), replacement of severely damaged tip cartilage, and/or rebuilding the entire bridge if it has been overly resected. 

The more surgeries that a patient has had, the more difficult, and more unpredictable this operation can become. This is due to a larger scar tissue burden, decreased blood supply to the tissues, and the need for more aggressive grafting. 

It can take 1-2 years to fully heal from a Primary Rhinoplasty (see Recovery), and often even longer for a Revision Rhinoplasty. Perfection is never achieved in Primary surgery, and certainly not in Revision surgery. However, major functional and cosmetic improvements are routinely accomplished